Stress Ulceration Risk Factors

The major risk factors are respiratory failure, coagulopathy, sepsis, hypotension and hepatic and renal failure.

This has been extensively studied: based on the two studies by Cooke’s group (2;4) , we know that patients with respiratory failure and with coagulopathy have significantly higher incidences of bleeding than other patients. The other major risk factors were sepsis, liver failure, hypotension and renal failure.

Overall, we know that there is a good relationship between severity of illness (as determined by, for example, Apache II scores) and incidence of ulceration. Moreover, the longer a patient is in ICU, the more likely they are to have a GI bleed (5). Patients who are likely to have a number of these risk factors – burns patients for example (ventilated, hypotensive, coagulopathic), are more likely to have ulceration and bleeding.

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